Variance Estimation and Confidence Intervals for 11 Commonly Used Health Disparity Measures
Variance Estimation and Confidence Intervals for 11 Commonly Used Health Disparity Measures
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DOI：
10.1200/cci.18.00031
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发表时间：
2018-09-10
影响因子：
4.2
通讯作者：
Luta, George
中科院分区：
文献类型：
--
作者：
Ahn, Jaeil;Harper, Sam;Luta, George
人们对消除美国和世界各地的健康差距越来越感兴趣。广义的健康差距是指健康状况中可预防的不平等，如癌症对种族、社会经济地位、性别、教育、环境和地理位置的不平等。要做出明智的卫生政策决策，必须准确衡量差距的大小并评估随时间推移的趋势。健康差距计算器(HD*Calc)是免费的统计软件，它计算了11个常用的健康差距衡量标准，并使用解析法或基于蒙特卡洛模拟的方法为这11个衡量标准提供了相应的95%的CI；然而，SES的推导和CI的覆盖属性尚未得到正式评估。我们使用模拟研究来评估这些CI的覆盖特性。我们还使用来自全国、州和县级SEER数据的年龄调整癌症发病率对HD*Calc中实施的措施进行了偏差分析。这些分析的结果表明，当零事件计数的比例大于25%时，在构建健康差距度量的CI时应谨慎使用HD*CALC。(C)2018年美国临床肿瘤学会
There is increased interest in eliminating health disparities in the United States and worldwide. Broadly defined, health disparities refer to preventable inequalities in health status, such as cancer to ethnicity, socioeconomic status, gender, education, environment, and geographic locations. To make informed health policy decisions, it is essential to precisely measure the magnitude of disparities and assess trends over time. The Health Disparities Calculator (HD*Calc) is free statistical software that calculates 11 commonly used measures of health disparities and provides corresponding 95% CIs for the 11 measures using either an analytic method or a Monte Carlo simulation-based method; however, the derivation of SEs and coverage properties of the CIs have not been formally evaluated. We used simulation studies to assess the coverage properties of these CIs. We have also conducted bias analyses for measures implemented in HD*Calc using age-adjusted cancer incidence rates from national, state, and county level SEER data. The results of these analyses indicate that HD*Calc should be used with caution to construct CIs for some health disparity measures when the proportion of zero event counts is greater than 25%. (C) 2018 by American Society of Clinical Oncology